Published on: 12/08/2011
When we enter the Rwangala village to find out how the Community Hygiene Club works in practice we see a large group of women in white WaterAid T-shirts wave goodbye to a leaving bus with participants from the AfricaSan 3 Conference in July 2011.
When we enter the Rwangala village to find out how the Community Hygiene Club works in practice we see a large group of women in white WaterAid T-shirts wave goodbye to a leaving bus with participants from the AfricaSan 3 Conference in July 2011. I am introduced first to Emile Gasirabo, the leader of this village in Kanzenze cell, sector Ntamara, district Bugesera in Eastern Province, 30 kilometres out of Kigali.
This village with 84 households is clearly a better off sort of model village. Apart from WaterAid it is also sponsored by the Nelson Mandela Foundation, because of the many surviving widows who started living here in 1996 after the genocide. But there is no electricity in the villages and the women get water from taps at 200 metre walking distance.
Johnson Nkusi, CEO of the Rwandan Environmental NGO Forum and Mr. Jackson Mugisha, Environment Facilitator of the Ministry of Local Government, explain to the group the reason of my visit. I want a few interviews, observations and a few pictures for a story that will be published internationally.
With a smaller group we squeeze into a small meeting room. There we talk to Marie Louise Uwigize who heads the Sanitation and Hygiene workers, Bering Musengamana, president of the Hygiene Club and Petronille Nkwibonzere, one of the four Community Health Workers (CHW), and Florence Umware, Member of the club.
Johnson Nkusi demonstrates the tippy tap, Photo: IRC/Dick de Jong 2011
Q: What do the Community Health Workers do?
Petronille: We sensitise the people in weekly meetings on different government hygiene and health programmes. Sometimes we talk on hygienic practises, HIV/AIDS prevention, malaria prevention and oral rehydration solution (ORS). Or we discuss with help of nutrition posters. We always use the open space for these sessions. Every last Saturday of the month there is a national sanitation service day (Umuganda). Three months ago we installed sanitation and hygiene slabs.
So far nearly 80 percent of the 15,000 villages in Rwanda has formed these hygiene clubs. Environmental Health Officers from the Ministry of Health has trained 45,000 Community Health Workers so far, on average three per village, as part of the Community Based Environmenmatl Health Promotion Programme that was launched in December 2009. The plan is to have 60,000 health workers trained in 2012 and to scale it up to all the 30 districts in the country.
Q: What kind of training did you get?
Petronille: We went through one week training of trainers on hygiene and sanitation by District Health Officers of the Ministry of Health at the Kigali Institute of Education. We were with more than 20 in June this year. We got a per diem. All hygiene clubs get this training.
Later the CHWs trained the club members, who in turn trained the communities in two days. Training tools and manuals have been developed and pre-tested using the Participatory Hygiene and Sanitation Transformation (PHAST) approach.
Q: Are the health workers paid?
Petronille: No, we are volunteers. It would be great if we got paid, but we are patriotic.
She continues that the government has helped them open a savings account at a local bank that can help micro-financing for local income generating activities or loans. But no one can answer my question on how much money they have in this account.
The villagers benefit occasionally from direct poverty reduction programmes funded by the European Union, World Bank, or by the Ministry of Rural Development. A cow for each family is an example of this kind of direct support.
For a quick reality check we visited two toilets and household compounds. Mrs. Thereza Mukankusi is a grandmother living together with her grandchild. Her washed kitchen utensils are drying on a rack on poles.
Photo: IRC/Dick de Jong, 2011
Her toilet is very clean. For handwashing she uses a Rwanda version of the tippy tap. With her foot on the stick she can operate it to get the water she needs to wash her hands. I observed the same in another compound.
Photo: IRC/Dick de Jong, 2011
The village is remarkably clean, compared to any other villages that I have written stories on elsewhere in the world. Kigali was also cleaner than any other major city I have seen. As plastic bags have been banned you see people carry the things they buy from shops and markets in brown bags of various sizes.
Rwanda is currently performing above the regional peer group average for both rural and urban sanitation in Africa, the Water and Sanitation Program concludes in their July 2011 benchmark overview of how African countries perform their service delivery pathways for turning finance into sanitation services. On the eThekwini Traffic Lights Report that show progress on the nine eThekwini commitments Rwanda scores seven score agree, meaning good progress. WSP scores the budget allocation and having a sanitation monitoring and evaluation system in place with a yellow, with some progress. According to Mrs Coletha Ruhamya, State Minister for Energy and Water, the government is currently spending 0.48 of the national GDP on sanitation (Rwanda Dispatch, July 2011, pp 8-11).
Under the tradition of mutual assistance (Ubudehe) the government has been building 16,000 toilets for the poorest in the last five years. Another traditional bottom-up practice, Imihigo Sanitation, people publicly committing themselves to the achievement of a given task was resurrected in 2006. This happens through contracts between the President, district mayors and city and town councils, resulting in increasing numbers of ecological sanitation toilet blocks on main roads, in parks and market places.
These achievements are the result of the Presidential Initiative on Sanitation. I totally agree with WSP’s conclusions: other countries can adapt and implement key elements from Rwanda’s package to improve access to sanitation and improved hygiene.
Dick de Jong